2016年11月23日星期三

VISION 2020



VISION 2020


The Right to Sight is the global initiative for the elimination of avoidable blindness, a joint programme of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB).


VISION 2020: The Right to Sight was launched in 1999. It sought to promote:


“A world in which nobody is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential.”


The Global Initiative was set up to:


“Intensify and accelerate prevention of blindness activities so as to achieve the goal of eliminating avoidable blindness by 2020.”


It sought to do this by:


“Focussing initially on certain diseases which are the main causes of blindness and for which proven cost effective interventions are available.”


The VISION 2020 Global Initiative has subsequently been complemented and built upon by a series of additional plans. In 2006 VISION 2020 stakeholders developed an action plan for the period 2006-11, which extended the remit to focus not only upon the elimination of avoidable blindness, but to include visual impairment – particularly that caused by uncorrected refractive error.


In addition four World Health Assembly resolutions (2003, 2006, 2009 and 2013) have reinforced the aim and objectives of VISION 2020. The last two resolutions were accompanied by WHO Action Plans which have provided more detail on how the objectives were to be achieved as well as refining some of the implementation approaches.


The most recent action plan “Universal Eye Health: A global action plan 2014 – 2019" (GAP) was unanimously adopted by Member States at the World Health Assembly in 2013 as part of WHA resolution 66.4. This latest plan has an overall vision that restates that of VISION 2020: The Right to Sight whilst adding a further dimension around “universal access to comprehensive eye care services.”


The GAP also sets itself a Global Target of “Reduction in prevalence of avoidable visual impairment by 25% by 2019” (compared to the baseline prevalence of 2010). This is now seen as a more realistic global target as to what can be achieved by the end of this decade, rather than the original VISION 2020 target of global elimination by 2020. Some individual countries may achieve, or be close to, elimination by 2020.


The long-term goal of both the GAP and VISION 2020 remain the same – to rid the world of avoidable blindness and visual impairment. It is a shocking fact that in the 21st Century there are still some 285m visually impaired and blind persons and that 80% of these cases could have been prevented or treated.


VISION 2020 has made a huge difference to global eye health and has been able to create a major focus in the countries and districts where action is needed.


Awareness of the VISION 2020 brand remains strong and the aims, aspirations, principles and approaches that were at the heart of the original Global Initiative remain in place to this day




2016年11月1日星期二

LOW VISION Telescopes

LOW VISION Telescopes
Definition
Low-vision devices are designed to improve visual performance in children with low vision, thus enabling academic and social adaptation and providing enrichment of daily experiences. They can be optical or optical and electronic.
Types of Devices Optical
When conventional lenses do not provide required visual range, aids that have optical properties capable of promoting better visual performance through lenses are indicated.
Types of optical aids for
  • Distance
  • Intermediate distance
  • Near
Optical Aids for Distance and Intermediate Distance
The telescopic system (TS) or telescope is an optical instrument that improves the resolution of an object by increasing the size of the image projected on the retina, making it closer. . It is available for far, near, and middle distances
Figure 1. Telescope for distant view.

A telescope enables greater participation in daily and social activities such as watching television and reading white boards, street signs, house and building numbers, billboards, and menu boards. On the other hand, restriction of visual field and illumination, difficulty in locating and focusing on objects quickly, and limited focus depth are disadvantages of the telescopes. Telescopes are not universally accepted due to expense, difficulty in using the devices, and asthetic considerations. Good coordination and training are essential.

Types of Telescopes
  • Galilean or Keplerian
  • Hand-held, spectacle-mounted, or clip-on
  • Monocular or binocular
  • Fixed focus, focusable telescope, or autofocus

Figure 2. Telescopes for distance, near, and middle distance.

Galilean Telescope
The Galilean telescope is a simple system consisting of 2 lenses:
  • Objective lens: convex (plus) lens, closest to the object
  • Ocular lens: minus lens, closest to the eye
The distance between the 2 lenses is determined by the difference in their focal lengths. The image produced is real and erect. It's lighter, shorter, and cheaper than the Keplerian type, thus the first-choice prescription for children. It is also the first choice in cases of peripheral field loss; in these cases, the lens order is designed in reverse (plus lens closer to the eye), providing a wider visual field.

Keplerian Telescope
Also known as astronomical or prismatic, the Keplerian telescope is an optical system that uses 2 convex (plus) lenses, the objective lens being of smaller diopter power than the ocular. The distance between the lenses is the sum of their focal lengths. The image is real and inverted, requiring a prism to reverse the image, making it longer and heavier. It produces greater visual field and better optical quality than Galilean type and costs more.
Hand-Held, Spectacle-Mounted, or Clip-On Telescope
A hand-held telescope is simpler, lighter, and cheaper than the Galilean and Keplerian types. It is particularly indicated for short activities and could be a first prescription choice for children (Figure 2).

A spectacle-mounted telescope leaves the hands free. It is useful for prolonged activities and activities that require visualization of details. However, they both weigh and cost more
The clip-on model has the advantages of both: It is lighter than the spectacle-mounted model, however, it can scratch the lenses and reduce the visual field to further distances.

Monocular or Binocular
A monocular telescope is indicated when there is a significant difference in visual acuity (VA) between the 2 eyes. It is more discreet, lighter, and cheaper. It can be used in the dominant or better-seeing eye. Binocular telescope is indicated when there is similar VA in both eyes, with the purpose of increasing the visual field, and for nystagmus. The binocular style both weighs and costs more than monocular (Figure 2)
.
Fixed-Focus, Focusable, or Autofocus Telescope
A fixed-focus telescope is indicated for children with poor motor coordination. Nowadays it is rarely prescribed; a focusable telescope reaches far, near, and intermediate distance and is preferred for and by children. The autofocus telescope both weighs and costs more and it does not constitute the first choice prescription for children.